甲氨蝶呤治疗眼瘢痕性类天疱疮的疗效

doi:10.3760/cma.j.cn115909-20200317-00098

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Abstract Objective: To evaluate the effectiveness and safety of methotrexate (MTX) for the treatment of patients with ocular cicatricial pemphigoid (OCP). Methods: This was a retrospective case series study. A review of patient records with OCP who received treatment with MTX in the Department of Ophthalmology of Tianjin Medical University General Hospital from September 2016 to August 2019 were analyzed. Five patients were involved, 2 males and 3 females. OCP inflammation and progression and the adverse reaction of MTX were evaluated. Results: Mean age at the onset of OCP was 51.8 years (range, 38-66 years). Mean age at the initiation of immunotherapy was 54.4 years (range, 39-68 years). Six eyes in 3 patients achieved quiescence, 2 eyes in 1 patient presented with partial activity, and 2 eyes in 1 patient presented with disease activity after being treated by MTX for 6 months. At 12 months of MTX treatment, 8 eyes in 4 patients achieved quiescence, and 2 eyes in 1 patient presented with disease activity and continuous progression over stage one of OCP. This patient received rituximab in combination with MTX at 12 months after MTX initiation. Adverse events included gastrointestinal reaction in 2 patients, mild liver enzyme elevation in 1 patient, and virus infection of the cornea of 1 eye in 1 patient after being treated with MTX for 10 months. No other severe adverse events were noted during the follow-up period. Conclusions: These retrospective data suggest that MTX is efficacious and well tolerated when included early in the treatment of OCP.

Key words： ocular cicatricial pemphigoid immunotherapy methotrexate

Received: 17 March 2020

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Fund: National Natural Science Foundation of China (81800815, 81800817)

Corresponding Authors: Hua Yan, Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China (Email: phuayan2000@163.com)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200317-00098 OR https://www.cjoovs.com/EN/Y2020/V22/I11/815

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